The High Fatality Rate of the Swine Flu in Mexico--Due to the Origin or Conditions?

[tekisui]

Is the death rate, and spread rate higher in Mexico because it originated there, or because the environmental/health conditions?

The reason I ask is, this will inevitably make it to third world countries, with conditions worse than those in Mexico. Will the effect be as deadly in those countries as it is in Mexico, or will it be similar to what we have seen so far in the US and other developed countries?

[HereSince1628]

1. IMO it's too early to know the answers

Sorry, but I think that's where it is at this time.

[Chiquitita]

3. US Hog Facility in Mexico (re post)

Sorry I've posted this again, but I think it's important...

Maybe because they are closer to the vector, which may be flies on untreated swine feces. The community in Mexico around the Smithfield owned Hog farm has been requesting an inquiry...

http://themoderatevoice.com/30074/source-of-swine-flu-m... /

"A publication called Grist is reporting that the swine flu outbreak may have been triggered by poor hygienic practices at the Perote, Vera Cruz, Mexico hog farming facilities of Smithfield Farms. Smithfield Farms is the “world’s largest hog producer and pork packager”:

On Friday, the U.S. disease-tracking blog Biosurveillance published a timeline of the outbreak containing this nugget, dated April 6 (major tip of the hat to Paula Hay, who alerted me to the Smithfield link on the Comfood listserv and has written about it on her blog, Peak Oil Entrepreneur):

Residents believed the outbreak had been caused by contamination from pig breeding farms located in the area. They believed that the farms, operated by Granjas Carroll, polluted the atmosphere and local water bodies, which in turn led to the disease outbreak. According to residents, the company denied responsibility for the outbreak and attributed the cases to “flu.” However, a municipal health official stated that preliminary investigations indicated that the disease vector was a type of fly that reproduces in pig waste and that the outbreak was linked to the pig farms. It was unclear whether health officials had identified a suspected pathogen responsible for this outbreak."

[HereSince1628]

4. I didn't think there is anything in that article on issues of virulence

I have no idea about the quality of Grist. I remember a Grist that was a tabloid that advertised for paper boys in Boy's Life in the 1950's.

The municipal health official's opinion is going to need to be confirmed by multiple studies.

The motivations to "not be responsible" are going to be huge, and so the need to be very careful with analysis will be huge as well.

[Chiquitita]

6. It's in the Mexican papers, not just Grist,

one of which is the Veracruz-based paper La Marcha which has the story today: http://www.marcha.com.mx/resumen.php?id=2128 30% of the population of La Gloria has been affedted

I'm assuming the US publications were taking the lead from the Mexican papers.

Here's a translation of a sample paragraph:

He said the citizens of the region had already presented the appropriate complaints, but federal authorities have not given the issue attention and, rather than getting federal support, they have been threatened by employess of Carroll Farms.

Dijo que los ciudadanos de la región ya presentaron las denuncias pertinentes, pero las dependencias federales no hacen caso de atender el asunto y en lugar de obtener apoyo de las autoridades, sólo consiguen ser amedrentados por personal de Granjas Carroll.

and, you're right, it says nothing about virulence, but my main concern was to publicize the assertiveness of the Mexican community in controlling the possible source of the problem. (I cannot start a thread because I'm new to DU).

[HereSince1628]

8. Nothing is going to be certain until confirming studies are done.

Like most other epidemics there will be a large number of quick studies that will very probably confound certainty and require yet more investigation to untangle

I am not saying that flies cannot be mechanical vectors of influenza, nor am I saying that poor hygiene wouldn't contribute to transport of viral particles which can survive for days out in the environment.

My point is that one assertion of a local health officer, even if that person is correct, isn't going to be sufficient to answer the question of origin of this strain with confidence. As to issues of virulence, once again no one knows enough at this time to be sure which character or characters of the virus, susceptible strata in the population, and environment are in play.

One thing which is reasonable to assume is that investigators will examine the classic epidemiological triad of agent, host, and environment and intersections between members of that triad of causation in order to gain understanding of this outbreak.

This event is going to be to focus of studies for years.

[Chiquitita]

11. I understand your caution, nevertheless (link)

We need to be talking to the Mexican experts. I say this not because I think we can come to any sort of quick conclusion, but in order to preempt the inevitable negative consequences this is going to have on Mexican/US relations unless the intertwined nature of our economies is consistently brought out...

"On Sunday, the state government of Veracruz confirmed swine influenza in a five-year-old girl in the village of La Gloria, located near a massive US-owned hog facility. The bodies of two other village children who died in February and March will be exhumed and tested for signs of the illness, local media reports said."



http://www.huffingtonpost.com/david-kirby/mexican-lawmaker-factory_b_191579.html

[HereSince1628]

12. Of course there is a need to hear from Mexican federal health officials.

But they are still in the early days of investigating this. I suspect very little is definitive at this moment. No one has published information on infected or sero-positive hogs from the La Gloria farm, yet. Even if it is highly suspect, we must wait for the evidence to be made public. There are pigs with swine-flu symptoms being killed on the other side of Mexico, we must see which if any of these farms match up to the human cases through lab-work.

You are right that everyone is going to want to assign blame to someone else. And it is a puzzle to me whether blame for the natural mutation of an influenza virus can or even should be assigned to someone or some nation.

Pre-emptively kicking blame around seems so many magnitudes less important than understanding and preventing a global pandemic.

One thing Bush has taught us about knowledge used for pre-emption...it is very likely to be laden with error.

[Bluenorthwest]

7. Ah, the Boy's Life mag you think of was 'Grit' not grist.

Grit is not a tabloid it is a rural life magazine. It is now published glossy. Around since the late 1800's.

[HereSince1628]

9. Thanks, such is memory of long past events.

[KharmaTrain]

2. Many Factors...

No doubt the economic and health conditions in Mexico have a lot to play in the number of deaths. But also, the time factor in detecting the flu. It could have quickly spread before Mexican authorities were aware of the outbreak and by the time they reacted there were deaths.

One thing I thought about was the quality of the food and water in that country. Many here are familiar with "tourista"...the little bugs and germs that are in foreign (non flouridated) water that could also help protect us from some diseases and work against those in other countries.

The thrid world problem is more of preventing and accessibility to care. I think a lot of this depends on how quickly this epedmic is attacked and how virulent the strain is. Seems the cases detected in the US are milder than what occured in Mexico...it could be the diet, the weather conditions...many factors. I just hope this is part of the natural flow of things. As a kid, I remember regular outbreaks of Hong Kong flu...and some that were real nasty. We survived. The hope here is that third world countries won't be affected adversely.

[Phoonzang]

5. No one knows, but I don't see why the people who caught it in Mexico and

traveled to the US or other countries would have contracted a different strain. It would make sense that the higher death rate was because of environmental conditions and health care differences.

[alcibiades_mystery]

10. I'd bet dollars to doughnuts that most of the unconventional fatalities (15-40 yr olds)

Can be pretty obviously correlated with poverty and lack of medical education, while the conventional fatality range (infants and young children, the elderly) has the usual variance.

I don't have any information on this at all, but I'd bet that most of the deaths among those you wouldn't usually expect to die from flu in modern health care systems occurred on the fringes of those systems - i.e., among the poor and uneducated who waited too long to seek treatment. And before you come in here with the "we don't have treatment!" bit, and your Michael Crichton education on virology, and your half-read book on the 1918 pandemic, I'm talking about specific treatment of symptoms that actually cause flu deaths, like high fever and pneumonia. We can't "cure" influenza, but we can mitigate the danger of its effects. That's why far fewer otherwise healthy people die of flu today than did 90 years ago.